This dataset covers various topics and is suitable for instruction-tuning general-purpose LLMs for diverse clinical use cases.

Recurrent exacerbations remain a common yet preventable outcome for many children with asthma. Machine learning (ML) algorithms using electronic medical records (EMR) could allow accurate identification of children at risk for exacerbations and facilitate referral for preventative comprehensive care to avoid this morbidity. We developed ML algorithms to predict repeat severe exacerbations (i.e. asthma-related emergency department (ED) visits or future hospital admissions) for children with a prior asthma ED visit at a tertiary care children's hospital. Retrospective pre-COVID19 (Feb 2017 - Feb 2019, N=2716) Epic EMR data from the Children's Hospital of Eastern Ontario (CHEO) linked with environmental pollutant exposure and neighbourhood marginalization information was used to train various ML models. We used boosted trees (LGBM, XGB) and 3 open-source large language model (LLM) approaches (DistilGPT2, Llama 3.2 1B and Llama-8b-UltraMedical). Models were tuned and calibrated then validated in a second retrospective post-COVID19 dataset (Jul 2022 - Apr 2023, N=1237) from CHEO. Models were compared using the area under the curve (AUC) and F1 scores, with SHAP values used to determine the most predictive features. The LGBM ML model performed best with the most predictive features in the final AIRE-KIDS_ED model including prior asthma ED visit, the Canadian triage acuity scale, medical complexity, food allergy, prior ED visits for non-asthma respiratory diagnoses, and age for an AUC of 0.712, and F1 score of 0.51. This is a nontrivial improvement over the current decision rule which has F1=0.334. While the most predictive features in the AIRE-KIDS_HOSP model included medical complexity, prior asthma ED visit, average wait time in the ED, the pediatric respiratory assessment measure score at triage and food allergy.

The rapid advancement of Large Language Models (LLMs) has stimulated interest in multi-agent collaboration for addressing complex medical tasks. However, the practical advantages of multi-agent collaboration approaches remain insufficiently understood. Existing evaluations often lack generalizability, failing to cover diverse tasks reflective of real-world clinical practice, and frequently omit rigorous comparisons against both single-LLM-based and established conventional methods. To address this critical gap, we introduce MedAgentBoard, a comprehensive benchmark for the systematic evaluation of multi-agent collaboration, single-LLM, and conventional approaches. MedAgentBoard encompasses four diverse medical task categories: (1) medical (visual) question answering, (2) lay summary generation, (3) structured Electronic Health Record (EHR) predictive modeling, and (4) clinical workflow automation, across text, medical images, and structured EHR data. Our extensive experiments reveal a nuanced landscape: while multi-agent collaboration demonstrates benefits in specific scenarios, such as enhancing task completeness in clinical workflow automation, it does not consistently outperform advanced single LLMs (e.g., in textual medical QA) or, critically, specialized conventional methods that generally maintain better performance in tasks like medical VQA and EHR-based prediction. MedAgentBoard offers a vital resource and actionable insights, emphasizing the necessity of a task-specific, evidence-based approach to selecting and developing AI solutions in medicine. It underscores that the inherent complexity and overhead of multi-agent collaboration must be carefully weighed against tangible performance gains. All code, datasets, detailed prompts, and experimental results are open-sourced at https://medagentboard.netlify.app/.

This dataset covers various topics and is suitable for instruction-tuning general-purpose LLMs for diverse clinical use cases.

The effective management of Emergency Department (ED) overcrowding is essential for improving patient outcomes and optimizing healthcare resource allocation. This study validates hospital admission prediction models initially developed using a small local dataset from a Greek hospital by leveraging the comprehensive MIMIC-IV dataset. After preprocessing the MIMIC-IV data, five algorithms were evaluated: Linear Discriminant Analysis (LDA), K-Nearest Neighbors (KNN), Random Forest (RF), Recursive Partitioning and Regression Trees (RPART), and Support Vector Machines (SVM Radial). Among these, RF demonstrated superior performance, achieving an Area Under the Receiver Operating Characteristic Curve (AUC-ROC) of 0.9999, sensitivity of 0.9997, and specificity of 0.9999 when applied to the MIMIC-IV data. These findings highlight the robustness of RF in handling complex datasets for admission prediction, establish MIMIC-IV as a valuable benchmark for validating models based on smaller local datasets, and provide actionable insights for improving ED management strategies.

Large Language Models (LLMs) have shown impressive capabilities in natural language processing, yet their use in sensitive domains like healthcare, particularly with Electronic Health Records (EHR), faces significant challenges due to privacy concerns and limited computational resources. This paper presents a compact LLM framework designed for local deployment in settings with strict privacy requirements and limited access to high-performance GPUs. We introduce a novel preprocessing technique that uses information extraction methods, e.g., regular expressions, to filter and emphasize critical information in clinical notes, enhancing the performance of smaller LLMs on EHR data. Our framework is evaluated using zero-shot and few-shot learning paradigms on both private and publicly available (MIMIC-IV) datasets, and we also compare its performance with fine-tuned LLMs on the MIMIC-IV dataset. The results demonstrate that our preprocessing approach significantly boosts the prediction accuracy of smaller LLMs, making them suitable for high-privacy, resource-constrained applications. This study offers valuable insights into optimizing LLM performance for sensitive, data-intensive tasks while addressing computational and privacy limitations.

People with learning disabilities have a higher mortality rate and premature deaths compared to the general public, as reported in published research in the UK and other countries. This study analyses hospitalisations of 9,618 patients identified with learning disabilities and long-term conditions for the population of Wales using electronic health record (EHR) data sources from the SAIL Databank. We describe the demographic characteristics, prevalence of long-term conditions, medication history, hospital visits, and lifestyle history for our study cohort, and apply machine learning models to predict the length of hospital stays for this cohort. The random forest (RF) model achieved an Area Under the Curve (AUC) of 0.759 (males) and 0.756 (females), a false negative rate of 0.224 (males) and 0.229 (females), and a balanced accuracy of 0.690 (males) and 0.689 (females). After examining model performance across ethnic groups, two bias mitigation algorithms (threshold optimization and the reductions algorithm using an exponentiated gradient) were applied to minimise performance discrepancies. The threshold optimizer algorithm outperformed the reductions algorithm, achieving lower ranges in false positive rate and balanced accuracy for the male cohort across the ethnic groups. This study demonstrates the potential of applying machine learning models with effective bias mitigation approaches on EHR data sources to enable equitable prediction of hospital stays by addressing data imbalances across groups.

Over the last ten years, the US Centers for Disease Control and Prevention (CDC) has organized an annual influenza forecasting challenge with the motivation that accurate probabilistic forecasts could improve situational awareness and yield more effective public health actions. Starting with the 2021/22 influenza season, the forecasting targets for this challenge have been based on hospital admissions reported in the CDC's National Healthcare Safety Network (NHSN) surveillance system. Reporting of influenza hospital admissions through NHSN began within the last few years, and as such only a limited amount of historical data are available for this signal. To produce forecasts in the presence of limited data for the target surveillance system, we augmented these data with two signals that have a longer historical record: 1) ILI+, which estimates the proportion of outpatient doctor visits where the patient has influenza; and 2) rates of laboratory-confirmed influenza hospitalizations at a selected set of healthcare facilities. Our model, Flusion, is an ensemble that combines gradient boosting quantile regression models with a Bayesian autoregressive model. The gradient boosting models were trained on all three data signals, while the autoregressive model was trained on only the target signal; all models were trained jointly on data for multiple locations. Flusion was the top-performing model in the CDC's influenza prediction challenge for the 2023/24 season. In this article we investigate the factors contributing to Flusion's success, and we find that its strong performance was primarily driven by the use of a gradient boosting model that was trained jointly on data from multiple surveillance signals and locations. These results indicate the value of sharing information across locations and surveillance signals, especially when doing so adds to the pool of available training data.

Hospitalizations that follow closely on the heels of one or more emergency department visits are often symptoms of missed opportunities to form a proper diagnosis. These diagnostic errors imply a failure to recognize the need for hospitalization and deliver appropriate care, and thus also bear important connotations for patient safety. In this paper, we show how data mining techniques can be applied to a large existing hospitalization data set to learn useful models that predict these upcoming hospitalizations with high accuracy. Specifically, we use an ensemble of logistics regression, na\"ive Bayes and association rule classifiers to successfully predict hospitalization within 3, 7 and 14 days of an emergency department discharge. Aside from high accuracy, one of the advantages of the techniques proposed here is that the resulting classifier is easily inspected and interpreted by humans so that the learned rules can be readily operationalized. These rules can then be easily distributed and applied directly by physicians in emergency department settings to predict the risk of early admission prior to discharging their emergency department patients.

A patient's risk for adverse events is affected by temporal processes including the nature and timing of diagnostic and therapeutic activities, and the overall evolution of the patient's pathophysiology over time. Yet many investigators ignore this temporal aspect when modeling patient outcomes, considering only the patient's current or aggregate state. In this paper, we represent patient risk as a time series. In doing so, patient risk stratification becomes a time-series classification task. The task differs from most applications of time-series analysis, like speech processing, since the time series itself must first be extracted. Thus, we begin by defining and extracting approximate risk processes, the evolving approximate daily risk of a patient.